In 1932, the United States Public Health Service and Tuskegee Institute began the Tuskegee Study of Untreated Syphilis in the Negro Male to record the natural history of syphilis and analyze differences between black and white men. The study involved 600 black men in Macon County, Alabama, 399 of whom had contracted syphilis and 201 of whom had not. It was supposed to last only 6 months, but would go on for 40 years, during which the men were merely told that they had “bad blood”. Participants received free medical exams, meals, and burial insurance, but they were never told that they had syphilis and were never treated for it. Many discovered their illness after registering for the draft in World War II, but they were still denied penicillin or an exit from the study.

In 1972, the Associated Press published a story that led to public outcry and the appointment of an Ad Hoc Advisory Panel that found the study ethically unjustified. The study ended and was followed by a class-action lawsuit that was settled out of court for 10 million dollars and lifetime medical benefits. For many, it was too late; by the 1970s, only 128 of the original 399 still lived, while 49 wives and 19 children had also contracted the disease. Despite a presidential apology, the Tuskegee Experiment remains a powerful symbol of American racism and government abuse of the poor.